Journal article
Survival after non-traumatic spinal cord injury: evidence from a population-based rehabilitation cohort in Switzerland.
- Buzzell A Swiss Paraplegic Research, Nottwil, Switzerland.
- Chamberlain JD Swiss Paraplegic Research, Nottwil, Switzerland.
- Gmünder HP Swiss Paraplegic Center, Nottwil, Switzerland.
- Hug K REHAB Basel, Basel, Switzerland.
- Jordan X Clinique Romand de Réadaption, Sion, Switzerland.
- Schubert M Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland.
- Brinkhof MWG Swiss Paraplegic Research, Nottwil, Switzerland. martin.brinkhof@paraplegie.ch.
- 2018-11-11
Published in:
- Spinal cord. - 2019
Adolescent
Adult
Aged
Cohort Studies
Female
Humans
Life Expectancy
Longitudinal Studies
Male
Middle Aged
Rehabilitation Centers
Retrospective Studies
Risk Factors
Spinal Cord Injuries
Survival Analysis
Switzerland
Young Adult
English
STUDY DESIGN
Observational cohort study.
OBJECTIVE
To investigate survival and life expectancy after NTSCI in Switzerland according to etiology.
SETTING
Specialized rehabilitation centers in Switzerland.
METHODS
Longitudinal data from the Swiss Spinal Cord Injury (SwiSCI) medical records study were used. Adjusted hazard ratios (HRs) and life expectancies were estimated using flexible parametric survival modeling.
RESULTS
One thousand four hundred and fifty individuals were admitted to first rehabilitation for NTSCI between 1990 and 2011, contributing 6137 cumulative person-years at risk and 528 deaths. With reference to persons with a degenerative disc disorder, the HR for mortality in individuals with NTSCIs from infections was 1.42 (95% CI 0.99-2.04), while risk in those with NTSCIs from vascular disorders was 1.28 (95% CI 0.97-1.68). Mortality risk was most pronounced in individuals with NTSCIs from malignant neoplasms (HR 6.32, 95% CI 4.79-8.34). Exemplified for males with an attained age of 60 years, a malignant etiology was associated with 1.7 life years remaining (LYR), as compared to 10.1 LYR for non-malignant etiologies. Males with an attained age of 60 years and a degenerative disc etiology were estimated to have 12.9 LYR.
CONCLUSIONS
This study contributes an evidence base for risk factors of mortality after NTSCI, reducing a considerable knowledge gap in survival after NTSCI. Survival and life expectancy estimates were highly differential between etiological groups, indicating a need for a heterogeneous clinical approach and dynamic health-care provisions for this growing population.
Observational cohort study.
OBJECTIVE
To investigate survival and life expectancy after NTSCI in Switzerland according to etiology.
SETTING
Specialized rehabilitation centers in Switzerland.
METHODS
Longitudinal data from the Swiss Spinal Cord Injury (SwiSCI) medical records study were used. Adjusted hazard ratios (HRs) and life expectancies were estimated using flexible parametric survival modeling.
RESULTS
One thousand four hundred and fifty individuals were admitted to first rehabilitation for NTSCI between 1990 and 2011, contributing 6137 cumulative person-years at risk and 528 deaths. With reference to persons with a degenerative disc disorder, the HR for mortality in individuals with NTSCIs from infections was 1.42 (95% CI 0.99-2.04), while risk in those with NTSCIs from vascular disorders was 1.28 (95% CI 0.97-1.68). Mortality risk was most pronounced in individuals with NTSCIs from malignant neoplasms (HR 6.32, 95% CI 4.79-8.34). Exemplified for males with an attained age of 60 years, a malignant etiology was associated with 1.7 life years remaining (LYR), as compared to 10.1 LYR for non-malignant etiologies. Males with an attained age of 60 years and a degenerative disc etiology were estimated to have 12.9 LYR.
CONCLUSIONS
This study contributes an evidence base for risk factors of mortality after NTSCI, reducing a considerable knowledge gap in survival after NTSCI. Survival and life expectancy estimates were highly differential between etiological groups, indicating a need for a heterogeneous clinical approach and dynamic health-care provisions for this growing population.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1038/s41393-018-0212-x
- PMID 30413804
- Persistent URL
- https://sonar.ch/global/documents/298667
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